THE JOURNEY TO ELDER JUSTICE TAKE THE EJ ROADMAP CHALLENGE
WHAT DO WE ALL HAVE IN COMMON? If you are breathing-you are aging!
THEN WHAT DOES ANTI-AGING MEAN?
WHY WE RE HERE To ensure that older Americans live with dignity and honor and free from abuse, neglect, and exploitation.
WHAT IS THE NATIONAL CENTER ON ELDER ABUSE (NCEA)? A national resource center dedicated to the prevention of elder mistreatment Established by the Administration on Aging (AoA) in 1988 Granted a permanent home at AoA / ACL in the 1992 amendments to Title II of the Older Americans Act
The NCEA disseminates information and provides technical assistance and training by: making news and resources available collaborating on and disseminating research providing training identifying information about promising practices and interventions operating a listserv providing subject matter expertise
OUR GOAL STATEMENT To improve the national response to elder abuse, neglect, and exploitation by gathering, housing, disseminating, and stimulating innovative, validated methods of practice, education, research, and policy. We will be the entity others look to when they need state-of-the-art information and we will be an entity that pushes the field forward.
CORE TARGETS Serve as a national authority on elder abuse, neglect, and exploitation Develop and employ a communications strategy listserv for professionals respond to requests from the lay public and professionals create and disseminate information materials Develop and maintain an information clearinghouse on all programs showing promise of success
IN SYNC WITH THE ELDER JUSTICE ROADMAP
WHERE ARE WE GOING? The Elder Justice Roadmap A Cohesive National Movement to Promote Elder Justice A national response to an emerging crisis CAUTION: Side trips and Detours along the way.
A GLOBAL EFFORT We are here
WHY ARE WE GOING? Elder Abuse is increasing at alarming rates as our population ages and is vastly underreported. We need to travel together to stay on track. Source: http://ageinplace.com/elder-abuse-2/elder-abuse-statistics-silent-epidemic-infographic/
Source: http://ageinplace.com/elder-abuse-2/elder-abuse-statistics-silent-epidemic-infographic/
WHO IS AT RISK? Source: http://ageinplace.com/elder-abuse-2/elder-abuse-statistics-silent-epidemic-infographic/
INTRODUCING FRANK 80 year old gentleman living independently in his home Veteran of Korean War, worked in insurance industry Married with 2 children, recently widowed Finances: owns home, pension, social security, $200 K savings
FRANK: MEDICAL ISSUES Diabetes Coronary artery disease Macular Degeneration Post Traumatic Stress Disorder
FRANK: CHANGE IN STATUS Drivers license withdrawn due to vision Unable to administer own medications Difficulty walking long distances Depressed and isolated
FRANK: FAMILY SOLUTION Daughter, Susan lives in Virginia but keeps in weekly phone contact. Son, Bobby lives locally, is divorced, unemployed and has a history of substance abuse. Bobby moves in with Frank to help manage his needs. Bobby s responsibilities: shopping, cooking, driving, medications, medical appointments, & paying bills.
PHYSICAL ABUSE D E F I N I T I O N The use of physical force that may result in bodily injury, physical pain, or impairment. May include: Striking, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. In addition, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse.
PHYSICAL ABUSE S I G N S & S Y M P T O M S bruises, black eyes, welts, lacerations, and rope marks; bone fractures, broken bones, and skull fractures; open wounds, cuts, punctures, untreated injuries in various stages of healing; sprains, dislocations, and internal injuries/bleeding; broken eyeglasses/frames, physical signs of being subjected to punishment, and signs of being restrained; laboratory findings of medication overdose or under utilization of prescribed drugs; elder's report of being hit, slapped, kicked, or mistreated; elder's sudden change in behavior; and caregiver's refusal to allow visitors to see an elder alone.
OUR EXPERTS ON PHYSICAL ABUSE Adult Protective Services http:www.napsa-now.org/ Domestic Violence personnel focused on Abuse in Later Life www.ncall.org Some trending in the medical field-www.ncea.aoa.gov research Dr. Laura Mosqueda
SEXUAL ABUSE D E F I N I T I O N Non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. It includes, but is not limited to, unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing. S I G N S & S Y M P T O M S bruises around the breasts or genital area; unexplained venereal disease or genital infections; unexplained vaginal or anal bleeding; torn, stained, or bloody underclothing; and an elder's report of being sexually assaulted or raped.
EXPERT GUIDES IN SEXUAL ABUSE www.ncall.org expert in domestic violence situations http://www.ltcombuds man.org/about- for abuse in long-term care facilities Local law enforcement
EMOTIONAL/PSYCHOLOGICAL ABUSE D E F I N I T I O N The infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an elderly person from his/her family, friends, or regular activities; giving an older person the "silent treatment;" and enforced social isolation are examples of emotional/psychological abuse. S I G N S & S Y M P T O M S being emotionally upset or agitated; being extremely withdrawn and non communicative or non responsive; unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking); and an elder's report of being verbally or emotionally mistreated.
EMOTIONAL/PSYCHOLOGICAL ABUSE GUIDES Local Adult Protective Services Seeking out a Neuropsychologist with a specialty in geriatrics Contact NCEA at www.ncea.aoa.gov or call 1-855-500-3537 (ELDR) for more resources
NEGLECT D E F I N I T I O N The refusal or failure to fulfill any part of a person's obligations or duties to an elder. Neglect may also include failure of a person who has fiduciary responsibilities to provide care for an elder (e.g., pay for necessary home care services) or the failure on the part of an in-home service provider to provide necessary care. Neglect typically means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to an elder.
NEGLECT S I G N S & S Y M P T O M S dehydration, malnutrition, untreated bed sores, and poor personal hygiene; unattended or untreated health problems; hazardous or unsafe living condition/arrangements (e.g., improper wiring, no heat, or no running water); unsanitary and unclean living conditions (e.g. dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing); and an elder's report of being mistreated.
NEGLECT GUIDES Local Adult Protective Services-www.napsa-now.org Local Law Enforcement Remember if you don t report-it hasn t happened!
FINANCIAL ABUSE D E F I N I T I O N The illegal or improper use of an elder's funds, property, or assets. Examples include, but are not limited to, cashing an elderly person's checks without authorization or permission; forging an older person's signature; misusing or stealing an older person's money or possessions; coercing or deceiving an older person into signing any document (e.g., contracts or will); and the improper use of conservatorship, guardianship, or power of attorney.
FINANCIAL ABUSE sudden changes in bank account or banking practice, including an unexplained withdrawal of large sums of money by a person accompanying the elder; Inclusion of additional names on an elder's bank signature card; unauthorized withdrawal of the elder's funds using the elder's ATM card; abrupt changes in a will or other financial documents; unexplained disappearance of funds or valuable possessions; substandard care being provided or bills unpaid despite the availability of adequate financial resources; discovery of an elder's signature being forged for financial transactions or for the titles of his/her possessions; sudden appearance of previously uninvolved relatives claiming their rights to an elder's affairs and possessions; unexplained sudden transfer of assets to a family member or someone outside the family; the provision of services that are not necessary; and an elder's report of financial exploitation.
FINANCIAL ABUSE GUIDES Federal Trade Commission www.ftccomplaintassistant.gov 1.877.382.4357 Internet Crime Complaint-www.ic3.gov Consumer Financial Protection Bureau-http://www.consumerfinance.gov/
SELF NEGLECT Characterized as the behavior of an elderly person that threatens his/her own health or safety. Self-neglect generally manifests itself in an older person as a refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions. The definition of self-neglect excludes a situation in which a mentally competent older person, who understands the consequences of his/her decisions, makes a conscious and voluntary decision to engage in acts that threaten his/her health or safety as a matter of personal choice.
SELF-NEGLECT dehydration, malnutrition, untreated or improperly attended medical conditions, and poor personal hygiene; hazardous or unsafe living conditions/arrangements (e.g., improper wiring, no indoor plumbing, no heat, no running water); unsanitary or unclean living quarters (e.g., animal/insect infestation, no functioning toilet, fecal/urine smell); inappropriate and/or inadequate clothing, lack of the necessary medical aids (e.g., eyeglasses, hearing aids, dentures); and grossly inadequate housing or homelessness.
SELF NEGLECT GUIDES Very difficult area-contact APS to report, but remember that individuals with capacity have the right to deny services and make choices for themselves. www.napsa-now.org
WHAT APS CAN DO Call the Police Request a 5150 File a report of a crime Suggest, persuade, and bargain with the victim to get help Arrange for Case Management Assess needs and link to services Assist victims and their families in developing individual care plans Recommend conservatorship
WHAT APS MAY NOT DO Enter the victim s home without permission Remove a person from their residence against their will Force a client to accept services
RIGHT TO SELF- DETERMINATION APS clients are, by definition, independent. They have the right to selfdetermination even if their choices do not serve their best interest.
FRANK: APS APS Social Worker visits home and interviews Frank and Bobby Determines that Frank is not aware of some bank withdrawals or a reverse mortgage on house Determines that Bobby has control of Frank s assets and is managing his medical care Refers case to FAST and EAFC
WHY IT TAKES A TEAM? C A S E S A R E C O M P L E X M U LT I - L AY E R E D R E Q U I R E M U LT I P L E E X P E R T S FA S T B R I N G S T O G E T H E R E X P E R T S IN M O N T H LY M E E T I N G TO D I S C U S S C A S E S B R O U G H T TO US F R O M A D U LT P R O T E C T I V E S E R V I C E S A N D T H E LT C O M B U D S M A N N O T AN I N V E S T I G AT O R Y A G E N C Y
ROLE OF THE LONG-TERM CARE OMBUDSMAN As mandated by state and federal law, Ombudsmen will Regularly make unannounced visits to Orange County long-term care facilities Mediate and attempt to resolve resident's concerns or problems in facilities Provide unbiased placement information and referrals to long-term care facilities
LTC OMBUDSMAN WILL ALSO- Investigate allegations of abuse and neglect Witness the signing of Advanced Health Care Directives in Skilled Nursing Facilities Report serious facility violations to state licensing agencies. Keep all complaints, communications, and investigations confidential unless resident gives permission to release.
FIVE COMMON FORMS OF UNDUE INFLUENCE: IT S WICKED! Withholding information Intimidating, threatening, coercing Charming, Kissing up Exploitive acting while a person is most vulnerable Deceiving, making false promises
WHAT ABOUT FRANK? 1. APS contacts Susan who flew out and arranged for Frank to move to Assisted Living 2. FAST contacted bank to negotiate concerning the Reverse Mortgage 3. Forensic Center referred the case to the police pending prosecution
HOW DO WE PREPARE? CUSTOMIZE YOUR JOURNEY If you are a family member. If you are in Social Services If you are in Legal Services If you are in Law Enforcement If you are a Student. It s all about building bridges, communication and patience
WHAT DO WE NEED Collaboration between Professionals, Public/Private partnerships, Multidisciplinary Teams Consumers-Telling their stories and participating in the process A National Voice that not only addresses problems but offers solutions White House Conference on Aging World Elder Abuse Awareness Day
DO SOMETHING NOW! TAKE THE PLEDGE I WILL DO EVERYTHING I CAN TO PREVENT AND REPORT ELDER ABUSE AND EXPLOITATION. I WILL never knowingly violate the trust of the elders with whom I come in contact. I WILL ensure that I know how to recognize elder abuse and exploitation and how to report it. I WILL strive to educate my family, friends and associates to know when, where and how to report suspected elder abuse and exploitation I WILL - created by MEAPA, the Maricopa Elder Abuse Prevention Alliance, in partnership with the Arizona Association of Area Agencies on Aging
NAPSA GLOBAL SUMMIT The Summit will take place on June 15th, 2015 at the Securities and Exchange Commission (SEC) in Washington, DC. Space is limited- register as soon as possible! 48
ADDITIONAL RESOURCES Ageless Alliance http://www.agelessalliance.org/ Contact NCEA at www.ncea.aoa.gov For more resources call: 1-855-500-3537 (ELDR)